Provider Demographics
NPI:1265864508
Name:CROSS, DONYETTA ALICE (NCC, LPCMH)
Entity Type:Individual
Prefix:MRS
First Name:DONYETTA
Middle Name:ALICE
Last Name:CROSS
Suffix:
Gender:F
Credentials:NCC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-4045
Mailing Address - Country:US
Mailing Address - Phone:302-494-0541
Mailing Address - Fax:
Practice Address - Street 1:116 W 41ST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2130
Practice Address - Country:US
Practice Address - Phone:302-494-0541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health